=====================================================
General NPI Number Information
=====================================================
NPI Number | 1831071562
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SAI PRASANNA YELAMARTHI FNP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/23/2025
-----------------------------------------------------
Last Update Date | 07/23/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2460 N CENTRAL EXPY STE 101
-----------------------------------------------------
City | RICHARDSON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75080-2780
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 972-644-1100
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3608 TUSCAN HILLS CIR
-----------------------------------------------------
City | DENTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76210-8066
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 972-345-6956
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 1004117
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------